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I authorize the following amount to be deducted from my pay for "A Little Change Makes a Big Difference." I agree that the deductions will continue until I give my employer's payroll department written notice that I wish to discontinue the deductions. I understand that I may discontinue the deductions at any time.

  • Your contribution is tax deductible to the extent allowed by law, as McLaren is a non-profit health care organization.
  • The payroll deduction is an after-tax deduction.
Note: Payroll Deduction to begin on next available pay period unless you specify otherwise.

MMG and Corporate employees are not eligible for payroll deduction.

(Typing your name here indicates that all of the above information is accurate and acts as your electronic signature.) *